| NPI | 1740600089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 088369) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 0883691) |
| Enumeration Date | 2014-04-25 |
| Last Update Date | 2026-05-14 |