| NPI | 1356575989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 13312) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH11030) |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2023-05-22 |