| NPI | 1851782445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA IMF94804) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA PCCI3181) |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2016-11-01 |