| NPI | 1275361024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041S0200X Social Worker, School (Licence: CO LSW.0009925410) |
| Additional Taxonomies | 1041S0200X Social Worker, School |
| Enumeration Date | 2024-07-23 |
| Last Update Date | 2024-07-31 |