NPI | 1932571544 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM 0176451) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NM 0176451) |
Enumeration Date | 2015-10-21 |
Last Update Date | 2016-04-05 |