| NPI | 1477239713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 120997) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2023-06-22 |
| Last Update Date | 2024-02-12 |