| NPI | 1023546439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34008928A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2021-02-10 |