NPI | 1427394626 |
---|---|
Professional Name | N/A N/A N/A |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 9447) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 9447) |
Enumeration Date | 2012-12-17 |
Last Update Date | 2023-04-17 |