NPI | 1245228493 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34000148A) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 34000148A) |
Enumeration Date | 2005-10-12 |
Last Update Date | 2018-04-23 |