| NPI | 1225345671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 119012) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 119012) |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2023-12-27 |