| NPI | 1871203190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AR P2408026) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AR P2408026) |
| Enumeration Date | 2022-11-28 |
| Last Update Date | 2024-09-05 |