| NPI | 1912459926 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: AR A1610127)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AR P1911135)  | 
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2016-10-26 | 
| Last Update Date | 2021-05-26 |