| NPI | 1043092273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CT MSW.007218) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 44.001525) |
| 1041S0200X Social Worker, School (Licence: CT C072023001328) | |
| Enumeration Date | 2023-10-23 |
| Last Update Date | 2024-03-16 |