| NPI | 1376406041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: WV AP00946220) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional | |
| 101YS0200X Counselor, School | |
| Enumeration Date | 2025-12-08 |
| Last Update Date | 2025-12-08 |