| NPI | 1982720074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS26218) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW18242) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2012-10-30 |