| NPI | 1124652987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 134341) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 372600000X Adult Companion | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2025-12-16 |