| NPI | 1427234053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 21741) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA 21741) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2023-03-17 |