| NPI | 1356765721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 2401) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YS0200X Counselor, School | |
| Enumeration Date | 2014-02-06 |
| Last Update Date | 2019-03-01 |