| NPI | 1730861501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: IN 33012047A) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2023-08-02 |
| Last Update Date | 2024-08-09 |