| NPI | 1225798333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041S0200X Social Worker, School (Licence: TX 69392) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 69392) |
| Enumeration Date | 2021-12-30 |
| Last Update Date | 2021-12-30 |