NPI | 1194103465 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041S0200X Social Worker, School (Licence: NY R021321-1) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY R021321-1) |
Enumeration Date | 2015-05-07 |
Last Update Date | 2015-05-07 |