| NPI | 1144417171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AR P1010071) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AR P10100171) |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2021-02-10 |