| NPI | 1962605469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA ASW 24131) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2013-05-13 |