| NPI | 1821189523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 22095) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS22095) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2022-04-27 |