| NPI | 1164687547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 97346) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA 63357) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2020-12-03 |