| NPI | 1952737017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KS 04255) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: KS 1538) |
| Enumeration Date | 2013-09-20 |
| Last Update Date | 2023-04-17 |