NPI | 1740626936 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 085215) |
Additional Taxonomies | 104100000X Social Worker (Licence: NY 086839) |
Enumeration Date | 2013-05-15 |
Last Update Date | 2021-02-03 |