| NPI | 1306214804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA APCC9095) |
| Additional Taxonomies | 101Y00000X Counselor |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2024-04-04 |