| NPI | 1851172787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN 9345) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TN 13492) |
| Enumeration Date | 2023-10-06 |
| Last Update Date | 2024-12-23 |