| NPI | 1003133810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 28548) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NM I-07166) |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2023-08-25 |