| NPI | 1831957406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041S0200X Social Worker School |
| Additional Taxonomies | 104100000X Social Worker |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2024-03-08 |
| Last Update Date | 2024-03-08 |