| NPI | 1437803137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: WA SC61312299) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG61272324) |
| Enumeration Date | 2022-02-10 |
| Last Update Date | 2024-08-26 |