| NPI | 1356149488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR 12254-C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 107932) |
| Enumeration Date | 2025-03-05 |
| Last Update Date | 2025-03-05 |