NPI | 1821493990 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA ASW108496) |
Additional Taxonomies | 175T00000X Peer Specialist |
Enumeration Date | 2014-10-30 |
Last Update Date | 2022-11-16 |