| NPI | 1831269877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS24535) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW14679) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2016-05-21 |