| NPI | 1164210100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YS0200X Counselor, School |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA LPCC20653) |
| Enumeration Date | 2025-04-29 |
| Last Update Date | 2025-11-12 |