| NPI | 1699899757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS17117) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 17117) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2025-04-17 |