| NPI | 1881878478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P0503017) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AR M0507007) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2014-12-26 |