| NPI | 1720129083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34005749A) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IN 33005193A) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2010-04-30 |