| NPI | 1831386747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN 3165) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AR 1502) |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2012-05-09 |