| NPI | 1205410131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 135853) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2021-05-06 |
| Last Update Date | 2026-02-10 |