| NPI | 1790294650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041S0200X Social Worker, School (Licence: NY 097605-1) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 097605-1) |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2022-07-21 |