| NPI | 1275661100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW24452) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW24452) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2013-06-17 |