| NPI | 1952727554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AR P1602025) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A1403048) |
| Enumeration Date | 2014-03-07 |
| Last Update Date | 2016-02-26 |