NPI | 1639494909 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 080355) |
Additional Taxonomies | 104100000X Social Worker (Licence: NY 064153) |
Enumeration Date | 2010-03-30 |
Last Update Date | 2024-03-05 |