| NPI | 1104545417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 104100000X Social Worker (Licence: DC LG200001379) |
| Enumeration Date | 2022-08-22 |
| Last Update Date | 2023-08-14 |