| NPI | 1023788965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA LPCC22218) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 10063) |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2026-03-16 |