| NPI | 1780775288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P0505033) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR P0505033) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-05-01 |