| NPI | 1841321106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AR A1710299) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AR F1710013) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2018-07-30 |