| NPI | 1760098925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 113568) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101Y00000X Counselor (Licence: CA 113568) | |
| 104100000X Social Worker | |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2023-12-13 |