| NPI | 1669229902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NH 6030) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09924855) |
| Enumeration Date | 2024-05-03 |
| Last Update Date | 2026-10-05 |