| NPI | 1629847157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 136787) |
| Additional Taxonomies | 372600000X Adult Companion |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2023-12-26 |
| Last Update Date | 2026-05-07 |