| NPI | 1730385170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: 6802073612) |
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: MI 6802073612) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2022-03-24 |