NPI | 1306120530 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 083728-1) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
104100000X Social Worker (Licence: NY 082205-1) | |
Enumeration Date | 2011-10-06 |
Last Update Date | 2023-12-08 |