| NPI | 1881860302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 077809-1) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 059689) |
| 207R00000X Internal Medicine (Licence: NY 77809) | |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2023-07-17 |