| NPI | 1578699252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA LCS 14530) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-04-30 |