| NPI | 1477281194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 112619) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 112619) |
| Enumeration Date | 2022-08-10 |
| Last Update Date | 2023-11-17 |