| NPI | 1295235406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW61339056) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCSW118091) |
| Enumeration Date | 2018-02-14 |
| Last Update Date | 2024-02-16 |