| NPI | 1205234937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 137316) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ACSW105741) |
| 104100000X Social Worker (Licence: CA ACSW105741) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2014-12-11 |
| Last Update Date | 2026-04-03 |