| NPI | 1669032553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AR P2305014) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A2103224) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2023-05-23 |