| NPI | 1588442610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CA APCC20990) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA APCC20990) |
| Enumeration Date | 2023-09-19 |
| Last Update Date | 2026-03-03 |