NPI | 1861018137 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: NY 108709) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 34833) |
Enumeration Date | 2020-06-22 |
Last Update Date | 2020-06-22 |