| NPI | 1023521010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 79029) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WA LW60897197) |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2026-03-09 |