| NPI | 1487133500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA ACSW95177) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2022-03-16 |