| NPI | 1962858217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 1041S0200X Social Worker, School |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2020-01-17 |