| NPI | 1558438747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW92899) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY R069295) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2023-09-11 |