| NPI | 1861830911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN 9694) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: HI 5306) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2025-03-05 |