| NPI | 1407289853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 093316-01) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 089069-1) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2024-07-25 |