| NPI | 1295522001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CA APCC18657) |
| Additional Taxonomies | 221700000X Art Therapist (Licence: 25-141) |
| Enumeration Date | 2025-04-23 |
| Last Update Date | 2025-04-23 |