| NPI | 1972809846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW118729) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 104100000X Social Worker (Licence: CA ASW79794) | |
| Enumeration Date | 2011-02-09 |
| Last Update Date | 2023-10-30 |