| NPI | 1043795958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P2006028) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AR A1807084) |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2025-11-26 |