| NPI | 1629085857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34004064A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149001127) |
| 1041C0700X Social Worker, Clinical (Licence: IN 87000616A) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2023-10-11 |