NPI | 1538256912 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NY PR0188581) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NJ 44SC01291400) |
Enumeration Date | 2006-10-06 |
Last Update Date | 2010-08-10 |