| NPI | 1992410377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LPC-9531) |
| Enumeration Date | 2023-01-19 |
| Last Update Date | 2024-11-07 |