| NPI | 1427643196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA ASW94271) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 173039) |
| Enumeration Date | 2021-03-04 |
| Last Update Date | 2021-08-03 |