| NPI | 1821573601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA R1331881218) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2019-11-25 |