NPI | 1689869273 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 082529) |
Additional Taxonomies | 104100000X Social Worker (Licence: NY 085486) |
Enumeration Date | 2007-09-07 |
Last Update Date | 2024-09-17 |