| NPI | 1558770131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY #092368) |
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: NY 8280452141) |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2014-08-07 |