| NPI | 1205634656 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 21595) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 10553) |
| Enumeration Date | 2025-03-03 |
| Last Update Date | 2025-12-20 |