| NPI | 1265556393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: IN 33001101A) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IN 35000427A) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2007-07-08 |