| NPI | 1952581183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 63900) |
| Additional Taxonomies | 104100000X Social Worker |
| 1041C0700X Social Worker, Clinical (Licence: CA ASW 27563) | |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2022-10-05 |