| NPI | 1033516349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN 7227) |
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: TN 9920) |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2024-03-05 |