NPI | 1003523416 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 093984-01) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149020512) |
Enumeration Date | 2022-11-04 |
Last Update Date | 2022-11-04 |