| NPI | 1225303118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 72038) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW31513) |
| Enumeration Date | 2012-03-12 |
| Last Update Date | 2024-11-21 |