| NPI | 1740909928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA ACSW109413) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 109413) |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2023-08-07 |