| NPI | 1497480552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW131345) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2022-07-21 |
| Last Update Date | 2025-07-04 |