NPI | 1811058761 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: NY 038177) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 6617) |
Enumeration Date | 2006-12-13 |
Last Update Date | 2025-09-11 |