| NPI | 1831387067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA LCSW69529) |
| 104100000X Social Worker (Licence: CA ASW26884) | |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2024-06-11 |