| NPI | 1942492418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34005408A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW2616) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2019-07-21 |