| NPI | 1427874882 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041S0200X Social Worker, School | 
| Additional Taxonomies | 104100000X Social Worker | 
| 171400000X Health & Wellness Coach | |
| Enumeration Date | 2024-12-02 | 
| Last Update Date | 2024-12-02 |