NPI | 1518048313 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW10762) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 073720-1) |
Enumeration Date | 2006-10-18 |
Last Update Date | 2012-11-15 |