| NPI | 1275242679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: IN 33008569A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34011938A) |
| Enumeration Date | 2022-11-15 |
| Last Update Date | 2025-11-11 |