| NPI | 1356573711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LC50079318) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DC LG50079006) |
| Enumeration Date | 2009-08-19 |
| Last Update Date | 2014-04-21 |