| NPI | 1730671868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA asw90716) |
| 101Y00000X Counselor | |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2023-05-16 |