NPI | 1275765257 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NY 083360) |
Additional Taxonomies | 104100000X Social Worker (Licence: NY 078782) |
Enumeration Date | 2009-08-10 |
Last Update Date | 2016-03-21 |