| NPI | 1831057264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09930693) |
| Additional Taxonomies | 104100000X Social Worker |
| 1041S0200X Social Worker, School | |
| Enumeration Date | 2026-01-14 |
| Last Update Date | 2026-01-14 |