| NPI | 1952665002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR 6516-C) |
| Additional Taxonomies | 104100000X Social Worker (Licence: AR 6516-M) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2015-10-20 |