| NPI | 1770816258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA LCSW85701) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA ASW30263) |
| Enumeration Date | 2009-09-15 |
| Last Update Date | 2023-08-16 |