| NPI | 1871296418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DC LG200006902) |
| Enumeration Date | 2023-03-23 |
| Last Update Date | 2026-05-29 |