| NPI | 1679026207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P0905051) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AR a1606079) |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2025-09-26 |