NPI | 1174134803 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: NY 109376) |
Additional Taxonomies | 1041S0200X Social Worker, School (Licence: NY 1414031201) |
Enumeration Date | 2020-08-14 |
Last Update Date | 2020-08-14 |