| NPI | 1144704123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA CG-60901237) |
| Enumeration Date | 2018-09-17 |
| Last Update Date | 2023-03-21 |