| NPI | 1982332318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 20721) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 372600000X Adult Companion | |
| Enumeration Date | 2022-08-12 |
| Last Update Date | 2025-10-01 |