| NPI | 1922329788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA CG60457405) |
| Additional Taxonomies | 372600000X Adult Companion |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2014-05-23 |