| NPI | 1982751574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker (Licence: MS M8249) |
| 104100000X Social Worker (Licence: TN LSW0000009067) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2019-02-28 |