| NPI | 1760039374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AR P2106018) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A1908014) |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2021-07-19 |