| NPI | 1568599439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW 20678) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CT 007093) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2010-07-28 |