| NPI | 1073193892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P221004) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A1809137) |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2023-05-17 |