| NPI | 1467261578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 99135175A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 99135174A) |
| Enumeration Date | 2025-01-03 |
| Last Update Date | 2026-03-04 |