| NPI | 1538944897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA APCC18450) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2023-08-25 |
| Last Update Date | 2025-01-31 |