| NPI | 1720479330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P2110001) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A1903043) |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2021-10-08 |