| NPI | 1033237441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW83308) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW19684) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2021-06-10 |