| NPI | 1932451614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN 8492) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TN 10820) |
| 104100000X Social Worker | |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2024-04-04 |