| NPI | 1023713070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DC LG50083696) |
| Enumeration Date | 2023-03-31 |
| Last Update Date | 2024-01-11 |