| NPI | 1346524410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CA PCI 18) |
| Additional Taxonomies | 101YS0200X Counselor School (Licence: CA PPS 120001848) |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2024-04-10 |