| NPI | 1225431349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW130166) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 130166) |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2025-08-04 |