| NPI | 1275887978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR 7302-C) |
| Additional Taxonomies | 104100000X Social Worker (Licence: AR 7302-M) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2018-07-16 |