| NPI | 1043658859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 98975) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 104100000X Social Worker | |
| 251B00000X Case Management | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2021-12-27 |