| NPI | 1023350717 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34003383A)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 87000445A)  | 
| Enumeration Date | 2013-03-21 | 
| Last Update Date | 2023-09-26 |