| NPI | 1730630583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 123805) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2024-07-22 |