| NPI | 1710512736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA APCC16912) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2026-09-22 |