| NPI | 1720277205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P0508056) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO P0508056) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2016-07-28 |