| NPI | 1710131727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA APCC13690) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 480015bp) |
| 101YM0800X Counselor, Mental Health (Licence: CA 00000529) | |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2023-08-15 |