| NPI | 1902687833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34010272A) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87001726A) |
| Enumeration Date | 2023-10-06 |
| Last Update Date | 2023-11-03 |