NPI | 1578921136 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 088641) |
Additional Taxonomies | 104100000X Social Worker (Licence: NY 077113-1) |
Enumeration Date | 2016-02-10 |
Last Update Date | 2019-10-30 |