| NPI | 1558732792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW113111) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA ASW113111) |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2023-05-19 |