| NPI | 1477377224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: WV BP00946780) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WV BP00946780) |
| Enumeration Date | 2024-11-08 |
| Last Update Date | 2024-11-08 |