| NPI | 1225027881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34004605A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: UT 331357-3501) |
| 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-17008) | |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2024-11-19 |