| NPI | 1346638764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW108444) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 89573) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2015-01-07 |
| Last Update Date | 2022-07-18 |