| NPI | 1407132434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AR P1505049) |
| 101YP2500X Counselor, Professional (Licence: AR P1505049) | |
| Enumeration Date | 2011-10-21 |
| Last Update Date | 2023-05-03 |