| NPI | 1356187199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW-113615) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: CA ASW-113615) |
| 101Y00000X Counselor (Licence: CA ASW-113615) | |
| Enumeration Date | 2024-07-02 |
| Last Update Date | 2024-09-12 |