| NPI | 1457071391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA LPCC22202) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 101Y00000X Counselor | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2026-03-27 |