| NPI | 1992249841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR 19-QMHPC-00686) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA IMF96134) |
| Enumeration Date | 2016-12-12 |
| Last Update Date | 2024-11-21 |