| NPI | 1003232711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 9980) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101Y00000X Counselor (Licence: CA 9980) | |
| 101YM0800X Counselor, Mental Health (Licence: CA 2134) | |
| 101YP2500X Counselor, Professional | |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2014-03-05 |
| Last Update Date | 2022-08-04 |