| NPI | 1619241601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: TN LSW0000008307) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IN 87001320A) |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2012-03-08 |