| NPI | 1134809510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW130506) |
| Additional Taxonomies | 104100000X Social Worker |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2023-07-20 |
| Last Update Date | 2025-06-03 |