| NPI | 1851461461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LC301894) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904002687) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2026-04-09 |