| NPI | 1053885400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 100228-01) |
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: NY 100228) |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2025-02-13 |