NPI | 1427662048 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA ASW95534) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW95534) |
Enumeration Date | 2020-09-01 |
Last Update Date | 2023-06-22 |