| NPI | 1669526232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA CP00004227) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WA RC00037756) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2020-12-04 |