| NPI | 1669809364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 085810) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 08979) |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2018-12-20 |