| NPI | 1972043792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P2110003) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AR A1810152) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2022-01-12 |