| NPI | 1093453532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CA APCC14859) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA APCC14859) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2022-05-24 |
| Last Update Date | 2025-08-28 |