| NPI | 1992036230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 10431) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL imh 5838) |
| Enumeration Date | 2010-01-27 |
| Last Update Date | 2020-09-23 |