| NPI | 1982995072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA ASW108075) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 108075) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2024-07-30 |