| NPI | 1184206476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA APCC17625) |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2026-03-25 |