| NPI | 1942038393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LG200002801) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 31030) |
| Enumeration Date | 2024-07-25 |
| Last Update Date | 2024-07-25 |