| NPI | 1326496423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: HI LCSW-4574) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34007463A) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2023-04-12 |