| NPI | 1033577531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW108254) |
| Additional Taxonomies | 104100000X Social Worker |
| 1041C0700X Social Worker, Clinical (Licence: CA 108254) | |
| 171M00000X Case Manager/Care Coordinator | |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2016-01-29 |
| Last Update Date | 2024-03-04 |