| NPI | 1093660987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MHCA.MC.70045244) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR R12452) |
| Enumeration Date | 2026-03-04 |
| Last Update Date | 2026-03-04 |