| NPI | 1881880557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA ASW27280) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2007-09-17 |
| Last Update Date | 2013-12-13 |