| NPI | 1376269779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR 11401-C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TN 9910) |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2025-10-03 |