| NPI | 1366028870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 21014) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA APCC9680) |
| 101Y00000X Counselor | |
| 101YP2500X Counselor, Professional (Licence: CA APCC9680) | |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2026-01-02 |