| NPI | 1265149306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 130855) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2022-10-28 |
| Last Update Date | 2026-07-17 |