| NPI | 1366709131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: AR P1601009) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2016-10-20 |