NPI | 1710575568 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 097784) |
Additional Taxonomies | 104100000X Social Worker (Licence: NY 091861) |
Enumeration Date | 2021-01-07 |
Last Update Date | 2024-06-07 |