NPI | 1598749780 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34003338A) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 34003338A) |
Enumeration Date | 2005-12-01 |
Last Update Date | 2009-04-29 |