| NPI | 1861876948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW77959) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA ASW77959) |
| 104100000X Social Worker | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2023-12-18 |