| NPI | 1538592340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041S0200X Social Worker, School |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: UT 390200000) |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2022-06-15 |