NPI | 1194835272 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NY PR019400-1) |
Additional Taxonomies | 104100000X Social Worker (Licence: NY PR0194001) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2023-01-20 |