| NPI | 1093993370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LC50081614) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AR 2467-C) |
| 1041S0200X Social Worker, School | |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2020-07-01 |