| NPI | 1871927079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LC50079764) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904014725) |
| 1041C0700X Social Worker, Clinical (Licence: MD 17431) | |
| Enumeration Date | 2013-08-25 |
| Last Update Date | 2025-09-06 |