| NPI | 1013521566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 93313) |
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: CA 93313) |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2023-04-19 |