| NPI | 1053442335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW70058) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA 34699) |
| 1041C0700X Social Worker, Clinical (Licence: CA 70058) | |
| 171M00000X Case Manager/Care Coordinator (Licence: CA 70058) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2022-02-22 |