| NPI | 1295759272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW14741) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS 14741) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2017-11-07 |