NPI | 1669755955 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: CA 128479) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 88372) |
Enumeration Date | 2011-09-22 |
Last Update Date | 2025-04-14 |