| NPI | 1528529336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 128937) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA 128937) |
| 1041C0700X Social Worker, Clinical (Licence: CA 128937) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2026-10-09 |