| NPI | 1841845542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P2208014) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 101YM0800X Counselor, Mental Health (Licence: AR A2010139) | |
| Enumeration Date | 2019-08-08 |
| Last Update Date | 2022-10-04 |