| NPI | 1346704897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09925768) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCSW24237) |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2022-04-21 |