| NPI | 1629364526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: HI LCSW-5304) |
| Additional Taxonomies | 104100000X Social Worker (Licence: HI 235) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2025-04-18 |