| NPI | 1982911848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW79533) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA ASW 33337) |
| 171M00000X Case Manager/Care Coordinator | |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2022-07-14 |