| NPI | 1538684709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN LSW0000007824) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TN 11335) |
| 104100000X Social Worker (Licence: TN 7824) | |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2023-08-16 |