| NPI | 1730420605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041S0200X Social Worker, School (Licence: NY ro35598-1) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 1041C0700X Social Worker, Clinical (Licence: NY r 035598-1) | |
| Enumeration Date | 2013-03-02 |
| Last Update Date | 2013-03-02 |