| NPI | 1003945890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 71550) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW 28646) |
| 1041C0700X Social Worker, Clinical (Licence: CA 51770) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2022-09-21 |