| NPI | 1699344341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN 8103) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TN LSW0000012424) |
| Enumeration Date | 2021-06-17 |
| Last Update Date | 2024-08-06 |