| NPI | 1598194268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 85966) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW67376) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2021-12-30 |