| NPI | 1619734217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 123541) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 72-P127407-01) |
| Enumeration Date | 2024-03-01 |
| Last Update Date | 2024-06-14 |