| NPI | 1841451051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AR A0706044) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional (Licence: AR P9010069) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2024-12-19 |