| NPI | 1417661158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: AZ LMSW-20399) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LMSW-20399) |
| 101YM0800X Counselor Mental Health (Licence: AZ LMSW-20399) | |
| 171400000X (Licence: AZ LMSW-20399) | |
| 175F00000X Naturopath (Licence: AZ LMSW-20399) | |
| 175L00000X Homeopath (Licence: AZ LMSW-20399) | |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2023-01-09 |