| NPI | 1457651689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 22958) |
| Additional Taxonomies | 225500000X Specialist/Technologist (Licence: CA 25705 Yoga Alliance) |
| Enumeration Date | 2010-10-21 |
| Last Update Date | 2010-10-21 |