| NPI | 1700076288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 077294) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCSW102876) |
| 1041C0700X Social Worker, Clinical (Licence: CA 102876) | |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2021-08-30 |