| NPI | 1942459557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 1022157) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 1012257) |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2008-09-18 |