| NPI | 1417732926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 116908) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA 116908) |
| Enumeration Date | 2023-08-31 |
| Last Update Date | 2024-12-13 |