| NPI | 1699810408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 14447) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 26844) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2013-05-29 |