| NPI | 1972322253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 26562) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 88002240A) |
| Enumeration Date | 2024-10-04 |
| Last Update Date | 2024-10-04 |