| NPI | 1538533351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 138071) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2026-04-23 |