NPI | 1316248545 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY P17652) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ SC 10222) |
Enumeration Date | 2010-11-04 |
Last Update Date | 2010-11-04 |