| NPI | 1043154909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 114439-01) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA SW143485) |
| Enumeration Date | 2026-04-20 |
| Last Update Date | 2026-04-20 |