| NPI | 1457682791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 081134) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 0801751) |
| Enumeration Date | 2010-01-27 |
| Last Update Date | 2013-09-26 |