| NPI | 1780876656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34002630A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 24589) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2024-12-27 |