| NPI | 1346811791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MA 229291) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 114918) |
| 104100000X Social Worker (Licence: NY 110333-01) | |
| Enumeration Date | 2021-07-07 |
| Last Update Date | 2023-06-14 |