| NPI | 1316600182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 113374) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 13374) |
| Enumeration Date | 2021-10-19 |
| Last Update Date | 2021-10-22 |