| NPI | 1669710042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW94690) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA ASW35792) |
| 104100000X Social Worker | |
| 171M00000X Case Manager/Care Coordinator (Licence: CA ASW35792) | |
| Enumeration Date | 2013-01-20 |
| Last Update Date | 2020-05-14 |