| NPI | 1689349029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CA APCC12003) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2021-08-09 |
| Last Update Date | 2022-07-29 |