| NPI | 1255923470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P2305022) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A2102202) |
| Enumeration Date | 2021-02-09 |
| Last Update Date | 2023-06-09 |