| NPI | 1437346921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW103033) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW63880) |
| 101YM0800X Counselor, Mental Health (Licence: CA ASW97927) | |
| 104100000X Social Worker (Licence: CA 24282) | |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2021-08-27 |