| NPI | 1669941662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 124819) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 1041S0200X Social Worker, School (Licence: CA 124819) | |
| Enumeration Date | 2018-11-19 |
| Last Update Date | 2025-10-13 |