| NPI | 1023581113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041S0200X Social Worker, School (Licence: CA 112421) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 112421) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2019-01-10 |
| Last Update Date | 2023-06-05 |