NPI | 1083011498 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 072765) |
Additional Taxonomies | 1041S0200X Social Worker, School (Licence: NY 610511) |
Enumeration Date | 2014-12-01 |
Last Update Date | 2014-12-01 |