| NPI | 1336416544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LC50079241) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 07995) |
| Enumeration Date | 2011-11-17 |
| Last Update Date | 2011-11-17 |