| NPI | 1831487834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 30098) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW 30098) |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2015-01-29 |