| NPI | 1740787688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041S0200X Social Worker, School |
| Additional Taxonomies | 104100000X Social Worker (Licence: NV 10675-M) |
| 1041C0700X Social Worker, Clinical (Licence: NV IC-2627) | |
| Enumeration Date | 2018-04-08 |
| Last Update Date | 2025-01-27 |