| NPI | 1225286834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 76292) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA ASW 29101) |
| 104100000X Social Worker | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2026-06-01 |