| NPI | 1659801330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW117757) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW78616) |
| 104100000X Social Worker (Licence: CA ASW78616) | |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2024-12-03 |