| NPI | 1952035578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA APCC16562) |
| Additional Taxonomies | 101Y00000X Counselor |
| 171M00000X Case Manager/Care Coordinator | |
| 172V00000X Community Health Worker | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-07-11 |
| Last Update Date | 2024-07-01 |