NPI | 1295725547 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY R047570) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC00654900) |
Enumeration Date | 2005-10-27 |
Last Update Date | 2020-02-05 |