| NPI | 1609938299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 9323) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 247200000X Technician, Other | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2025-06-18 |