| NPI | 1386538577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 1041S0200X Social Worker, School |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2025-06-04 |
| Last Update Date | 2025-06-04 |