| NPI | 1003251661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LC50078213) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 12346) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2021-02-24 |