| NPI | 1275075269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA ACSW93874) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW93874) |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2024-11-21 |