| NPI | 1386092237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 92984) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA ASW70424) |
| 1041C0700X Social Worker, Clinical (Licence: IN 34009090A) | |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2023-11-01 |