| NPI | 1316719453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: HI LCSW-5268) |
| Additional Taxonomies | 104100000X Social Worker (Licence: HI 3114) |
| Enumeration Date | 2023-10-23 |
| Last Update Date | 2025-02-09 |