| NPI | 1568009421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA ASW113520) |
| Additional Taxonomies | 104100000X Social Worker |
| 224Z00000X Occupational Therapy Assistant (Licence: CA OTA2005) | |
| Enumeration Date | 2019-12-10 |
| Last Update Date | 2024-10-10 |