| NPI | 1528811973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: CO LSW.0009923969) |
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: CO SSW24468284) |
| Enumeration Date | 2024-04-08 |
| Last Update Date | 2024-11-19 |