| NPI | 1639771090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 123109) |
| Additional Taxonomies | 104100000X Social Worker (Licence: AZ LMSW-22136) |
| 104100000X Social Worker (Licence: CT MSW.010216) | |
| 104100000X Social Worker (Licence: NJ 44SL07091300) | |
| 104100000X Social Worker (Licence: PA SW141953) | |
| 133V00000X Dietitian, Registered (Licence: NY 010678) | |
| 133V00000X Dietitian, Registered (Licence: 86006908) | |
| Enumeration Date | 2020-11-11 |
| Last Update Date | 2024-09-25 |