| NPI | 1922615657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 108307) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 108307-01) |
| Enumeration Date | 2020-09-27 |
| Last Update Date | 2025-03-17 |