| NPI | 1477326270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA ASW128675) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2023-11-02 |
| Last Update Date | 2025-02-14 |