| NPI | 1922550268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39004060A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178.012351) |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2022-08-29 |