NPI | 1568469807 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY R027769) |
Additional Taxonomies | 104100000X Social Worker (Licence: NY R027769) |
1041S0200X Social Worker, School | |
Enumeration Date | 2005-07-01 |
Last Update Date | 2014-11-10 |