| NPI | 1336838903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW114264) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 114264) |
| Enumeration Date | 2023-05-01 |
| Last Update Date | 2025-01-28 |