| NPI | 1568132462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AR P2403003) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AR F2108002) |
| Enumeration Date | 2021-09-14 |
| Last Update Date | 2024-03-13 |