| NPI | 1598209132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: DC LC200002128) |
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: DC LG50080573) |
| Enumeration Date | 2016-12-16 |
| Last Update Date | 2023-06-05 |