| NPI | 1306984281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 104100000x) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95161014) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2019-01-31 |