| NPI | 1437938552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 225X00000X Occupational Therapist (Licence: CA 25196) | |
| Enumeration Date | 2023-09-27 |
| Last Update Date | 2023-09-27 |