| NPI | 1558210666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1529831023) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 101Y00000X Counselor | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2026-01-23 |
| Last Update Date | 2026-01-23 |