| NPI | 1205436334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA LPCC21768) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 8907) |
| Enumeration Date | 2020-10-28 |
| Last Update Date | 2026-02-09 |