| NPI | 1336858133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34011640A) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IN 33011069A) |
| 104100000X Social Worker (Licence: KY 257319) | |
| Enumeration Date | 2022-11-21 |
| Last Update Date | 2026-05-22 |