| NPI | 1164263695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 126598) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW126598) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2024-06-06 |
| Last Update Date | 2025-08-20 |