| NPI | 1316901358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YS0200X Counselor, School |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C003550) |
| 1041S0200X Social Worker, School (Licence: NC C003550) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2007-07-08 |