| NPI | 1831298694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 77006) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA LW00009084) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2018-11-29 |