| NPI | 1124271051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR 9792-M) |
| Additional Taxonomies | 104100000X Social Worker (Licence: AR 9792-M) |
| 1041S0200X Social Worker, School (Licence: AR 9792-M) | |
| 101YM0800X Counselor, Mental Health (Licence: AR 9792-M) | |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2026-03-11 |