| NPI | 1659928455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA 82942) |
| 104100000X Social Worker (Licence: CA 117750) | |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2024-12-02 |