NPI | 1881013423 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: NY 72091303) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 090645) |
Enumeration Date | 2014-04-10 |
Last Update Date | 2021-03-02 |