| NPI | 1326303488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 083187-1) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 078531-1) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2024-11-21 |