| NPI | 1851974968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 96084) |
| 104100000X Social Worker (Licence: CA 96084) | |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2023-07-17 |