| NPI | 1114063765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P1810134) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AR A1608108) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2019-06-10 |