| NPI | 1093970378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW23674) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS23674) |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2022-07-05 |