| NPI | 1265087274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR 8857-C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AR 8857-M) |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2022-11-29 |