| NPI | 1376377796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AR A2408010) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AR A2408010) |
| Enumeration Date | 2024-08-28 |
| Last Update Date | 2024-09-09 |