| NPI | 1699899922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW24940) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW 10590) |
| 1041C0700X Social Worker, Clinical (Licence: CA 24940) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2018-11-02 |