NPI | 1023458841 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 086097) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 092281-1) |
Enumeration Date | 2013-06-25 |
Last Update Date | 2022-12-01 |