| NPI | 1245959345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA ASW116513) |
| Additional Taxonomies | 104100000X Social Worker |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2023-07-25 |