| NPI | 1891170288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A2006082) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2023-01-05 |