| NPI | 1417413832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AR P2101132) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A1808111) |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2021-01-14 |