| NPI | 1700326279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P2406001) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A2208027) |
| Enumeration Date | 2017-03-03 |
| Last Update Date | 2024-06-05 |