| NPI | 1902056682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AR P1107048) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AR A0711095) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2021-03-11 |