| NPI | 1689206971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P2401015) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A2007103) |
| Enumeration Date | 2020-02-05 |
| Last Update Date | 2024-02-01 |