| NPI | 1043440829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 29152) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 29152) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2018-09-25 |