| NPI | 1013318989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA ACSW75434) |
| Additional Taxonomies | 104100000X Social Worker |
| 104100000X Social Worker (Licence: CA ASW75434) | |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2019-03-14 |