| NPI | 1033545579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34007526A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 33005340A) |
| Enumeration Date | 2013-09-16 |
| Last Update Date | 2021-03-03 |