| NPI | 1881861201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 6028) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AR A0701001) |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2016-03-22 |