| NPI | 1932653078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 115168) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA ASW93324) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2023-05-12 |