| NPI | 1275253023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW112889) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 104100000X Social Worker | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2023-06-23 |