| NPI | 1053690206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P1509096) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR P1509096) |
| 101YM0800X Counselor, Mental Health (Licence: AR F1402005) | |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2015-11-09 |