| NPI | 1023185196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: IN 34000761A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34000761A) |
| 106H00000X Marriage & Family Therapist (Licence: IN 34000761A) | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2015-10-05 |