| NPI | 1548384951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS 15834) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 15834) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2021-08-26 |