| NPI | 1497271142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM C-12082) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NM M10037) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2025-10-06 |