| NPI | 1689633778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AR P0603014) |
| Additional Taxonomies | 104100000X Social Worker (Licence: AR 1269-B) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2007-07-08 |