| NPI | 1215016100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 059616-1) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: NY 059616-1) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2007-08-22 |