| NPI | 1427930163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 20066) |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor (Licence: 745590) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2025-07-23 |
| Last Update Date | 2025-07-30 |