| NPI | 1588050165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 106636) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2023-04-24 |