| NPI | 1033444963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LC50078816) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: DC LMFT000056) |
| Enumeration Date | 2009-10-09 |
| Last Update Date | 2009-10-09 |