| NPI | 1124591441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 100874) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 101YM0800X Counselor, Mental Health (Licence: CA ACSW100874) | |
| 1041C0700X Social Worker, Clinical (Licence: CA 100874) | |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2024-10-24 |