| NPI | 1922771468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN 7871) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TN 12230) |
| Enumeration Date | 2021-07-30 |
| Last Update Date | 2024-10-30 |