| NPI | 1346950094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AR P2308010) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A2111003) |
| Enumeration Date | 2022-12-02 |
| Last Update Date | 2024-06-17 |