| NPI | 1073829545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 80898) |
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: NY 0899109) |
| Enumeration Date | 2010-08-23 |
| Last Update Date | 2020-06-30 |