| NPI | 1093821043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW12016) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C008703) |
| 1041C0700X Social Worker, Clinical (Licence: NY R040648-1) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2021-12-27 |