| NPI | 1588232144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: DC LG50080854) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: DC LG50080854) |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2026-04-08 |