| NPI | 1417441148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 127132) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 104100000X Social Worker (Licence: CA ASW97474) | |
| Enumeration Date | 2018-06-16 |
| Last Update Date | 2024-11-08 |