| NPI | 1487427290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA ASW118685) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA 118685) |
| Enumeration Date | 2023-11-02 |
| Last Update Date | 2024-03-13 |