| NPI | 1649884560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P2306001) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A1906072) |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2026-01-27 |