| NPI | 1891062725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: IN 33000992A) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87000955A) |
| Enumeration Date | 2011-11-21 |
| Last Update Date | 2013-02-06 |