NPI | 1720335250 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 084220) |
Additional Taxonomies | 104100000X Social Worker (Licence: NY 086952) |
Enumeration Date | 2012-08-15 |
Last Update Date | 2022-07-21 |