| NPI | 1952954471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AR P22110010) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AR A1907095) |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2022-12-13 |