| NPI | 1558609420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 088704) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2024-03-08 |