| NPI | 1538288998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS 29234) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA ASW19954) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2014-06-25 |