| NPI | 1326433343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2020006908) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2022-08-05 |