| NPI | 1013576081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 136802) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA ASW84573) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2026-06-15 |