| NPI | 1952956971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CA ASW95990) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 101YM0800X Counselor Mental Health (Licence: CA 95990) | |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2021-09-22 |