| NPI | 1366115529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR 11188-C) |
| Additional Taxonomies | 104100000X Social Worker (Licence: AR 11188-M) |
| Enumeration Date | 2021-07-26 |
| Last Update Date | 2024-03-14 |