| NPI | 1326404211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 119121) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34008169A) |
| Enumeration Date | 2016-01-07 |
| Last Update Date | 2024-10-14 |