| NPI | 1851830749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA ASW129537) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA 129537) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2026-05-14 |