| NPI | 1104340975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P2010094) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2025-10-15 |