| NPI | 1881958353 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: DC NP1013669) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical | 
| 163W00000X Registered Nurse (Licence: DC RN1013669) | |
| 163WC0400X Registered Nurse, Case Management (Licence: DC RN1013669) | |
| 171M00000X Case Manager/Care Coordinator | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2012-06-29 | 
| Last Update Date | 2025-08-19 |