| NPI | 1740680909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L11117) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCSW117885) |
| 372600000X Adult Companion | |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2025-01-05 |