| NPI | 1689718249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: IN 33000632A) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87000046A) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2012-01-19 |