| NPI | 1578693057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041S0200X Social Worker, School (Licence: NM M 5657) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NM M 05657) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2025-09-11 |