| NPI | 1538646948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 124134) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ACSW84510) |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2024-08-02 |