| NPI | 1336516731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA ACSW108278) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA ACSW108278) |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2022-08-31 |