| NPI | 1073752275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P2305012) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR P2305012) |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2026-02-27 |