| NPI | 1497121842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P1807082) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A1508111) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2021-08-17 |