| NPI | 1558404913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN ASW0000000019) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TN CSW0000005740) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2023-09-06 |