| NPI | 1861797227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AR 12-02 AE-PL) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR 10-57AE-PL) |
| 101YM0800X Counselor, Mental Health (Licence: AR 10-50 AE-PL) | |
| Enumeration Date | 2011-01-17 |
| Last Update Date | 2012-02-24 |