| NPI | 1831788371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 107616) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CT 5389) |
| Enumeration Date | 2021-01-11 |
| Last Update Date | 2021-01-11 |