| NPI | 1346569878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L13496) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW31711) |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2022-09-28 |