| NPI | 1891984571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN LSW0000004802) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 1041C0700X Social Worker, Clinical (Licence: MS C10431) | |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2023-12-05 |