| NPI | 1891856910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MO SW 002922) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 002922) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2022-09-29 |