| NPI | 1518606953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 111179) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW93903) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2022-06-02 |
| Last Update Date | 2024-02-26 |