| NPI | 1740825298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 100180) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 089352) |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2023-02-26 |