| NPI | 1922586502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34009442A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801103121) |
| Enumeration Date | 2018-08-05 |
| Last Update Date | 2021-09-28 |