| NPI | 1144078213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 123529) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MD 31570) |
| Enumeration Date | 2024-05-13 |
| Last Update Date | 2024-05-30 |