| NPI | 1891329918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LC200002340) |
| Additional Taxonomies | 104100000X Social Worker (Licence: DC LG50083203) |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2023-09-25 |