| NPI | 1609512912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6851116777) |
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: MI 6852090555) |
| Enumeration Date | 2022-05-10 |
| Last Update Date | 2024-09-17 |