| NPI | 1689794828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P0606035) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A0201006) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2020-09-01 |