| NPI | 1295375525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 083567-01) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 083567) |
| Enumeration Date | 2020-01-15 |
| Last Update Date | 2021-11-11 |