| NPI | 1730671868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW133169) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor Mental Health (Licence: CA ASW133169) | |
| 104100000X Social Worker | |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2025-08-18 |