| NPI | 1811525686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW98084) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ASW94084) |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2025-06-11 |