| NPI | 1467778175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR 2593-C) |
| Additional Taxonomies | 104100000X Social Worker (Licence: LA GSW#10506) |
| 104100000X Social Worker (Licence: AR 2440-M) | |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2015-04-14 |