| NPI | 1225791098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 118377) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 37294) |
| 104100000X Social Worker | |
| Enumeration Date | 2021-10-19 |
| Last Update Date | 2022-11-23 |