| NPI | 1598257453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YS0200X Counselor, School (Licence: CA 230235025) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2024-11-06 |