| NPI | 1982991469 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 104100000X Social Worker (Licence: FL SW8918) | 
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: FL 993601) | 
| Enumeration Date | 2011-07-05 | 
| Last Update Date | 2023-07-19 |