| NPI | 1235635012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 131996) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2025-07-21 |