| NPI | 1235478660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 85924) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 171M00000X Case Manager/Care Coordinator (Licence: CA 85924) | |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2023-08-10 |