| NPI | 1376939488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW120905) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA ASW84446) |
| 174400000X Specialist | |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2024-08-08 |