| NPI | 1427297126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NY R043381) |
| Additional Taxonomies | 1041S0200X Social Worker School (Licence: NY R043381) |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2009-02-19 |