| NPI | 1518042431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: IN 34002595A) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IN 35000366A) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2024-04-25 |