NPI | 1881638815 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34001642A) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39001098A) |
106H00000X Marriage & Family Therapist (Licence: IN 35000874A) | |
163W00000X Registered Nurse (Licence: IN 28169390A) | |
Enumeration Date | 2006-06-16 |
Last Update Date | 2016-04-05 |