| NPI | 1407928815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AR P8807011) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AR P8807011) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AR P8807011) | |
| 101Y00000X Counselor (Licence: AR P8807011) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2011-01-17 |