| NPI | 1407351562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P2201001) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AR A1807075) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2022-01-31 |