| NPI | 1003356296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 14111) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NV CP5873-R) |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2026-07-24 |