| NPI | 1205976289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS 23989) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NV 7334-C) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2023-10-27 |