| NPI | 1881861714 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34008795A) | 
| Additional Taxonomies | 104100000X Social Worker | 
| 1041C0700X Social Worker, Clinical (Licence: IN 99095687A) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2008-05-09 | 
| Last Update Date | 2023-08-07 |