| NPI | 1184857369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AR P1106034) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR P110604) |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2021-08-12 |