| NPI | 1447380225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 077392) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 069871) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2024-05-13 |