| NPI | 1245732486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CA 14705) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: CA 7917) |
| Enumeration Date | 2018-03-04 |
| Last Update Date | 2023-09-21 |