NPI | 1518113265 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 078171-1) |
Additional Taxonomies | 104100000X Social Worker (Licence: NY 076227-1) |
Enumeration Date | 2008-08-13 |
Last Update Date | 2011-01-21 |