NPI | 1336272558 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: NY RO21140) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NY RO21140) |
Enumeration Date | 2007-03-14 |
Last Update Date | 2013-09-24 |