| NPI | 1205010766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA RC00032146) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2024-08-15 |