| NPI | 1255026175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW109484) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW109484) |
| Enumeration Date | 2023-04-06 |
| Last Update Date | 2023-06-14 |