| NPI | 1144009887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: FL ISW14032) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: IN 34010797A) |
| 1041C0700X Social Worker Clinical (Licence: VA 0904016094) | |
| Enumeration Date | 2023-09-22 |
| Last Update Date | 2024-10-23 |