| NPI | 1851044747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 113918) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 113918) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-01-31 |
| Last Update Date | 2023-04-07 |