| NPI | 1891279287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker (Licence: IN 34008256A) |
| 104100000X Social Worker (Licence: IL 149.020534) | |
| Enumeration Date | 2018-09-20 |
| Last Update Date | 2024-12-03 |