| NPI | 1720229909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 079858) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 077481) |
| Enumeration Date | 2009-03-17 |
| Last Update Date | 2013-07-31 |