NPI | 1588437073 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NY 097819) |
Additional Taxonomies | 104100000X Social Worker (Licence: NY 097819) |
Enumeration Date | 2023-11-06 |
Last Update Date | 2023-11-06 |