| NPI | 1922247394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 079474-1) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 078533-1) |
| Enumeration Date | 2009-02-09 |
| Last Update Date | 2012-04-02 |