| NPI | 1396091757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LC303266) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 10184) |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2021-04-06 |