| NPI | 1053862441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA ASW105909) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 104100000X Social Worker (Licence: CA ASW105909) | |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2022-04-12 |