| NPI | 1992314694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH23983) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39005418A) |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2026-03-27 |