| NPI | 1831440247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 086188) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 086286) |
| 225A00000X Music Therapist (Licence: NY 001149) | |
| Enumeration Date | 2012-09-25 |
| Last Update Date | 2020-05-21 |