| NPI | 1740787688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NV 10675-M) |
| Additional Taxonomies | 104100000X Social Worker |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2018-04-08 |
| Last Update Date | 2023-05-25 |