| NPI | 1275904658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 99175) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW73410) |
| 1041C0700X Social Worker, Clinical (Licence: CA 390200000X) | |
| 104100000X Social Worker (Licence: CA 101Y00000X) | |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2021-12-27 |