| NPI | 1578732863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LC303458) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 06666) |
| 1041C0700X Social Worker, Clinical (Licence: VA 0904004705) | |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2008-02-21 |