| NPI | 1023149325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS26448) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS-26448) |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2021-08-16 |