| NPI | 1619836616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 26555) |
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: CA 26555) |
| Enumeration Date | 2026-01-16 |
| Last Update Date | 2026-01-16 |