| NPI | 1649848631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA LPCC18499) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA APCC12320) |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2025-01-22 |