| NPI | 1073841219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P1602012) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A1305059) |
| Enumeration Date | 2009-11-30 |
| Last Update Date | 2016-02-29 |