| NPI | 1467594937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA ASW16770) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 26515) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2023-03-06 |