| NPI | 1447470927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 093684-01) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL 7747) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2023-03-17 |