| NPI | 1962720276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH-8808) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AL 2696) |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2011-12-22 |