NPI | 1922617190 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 088349) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC06173900) |
Enumeration Date | 2020-07-23 |
Last Update Date | 2023-10-05 |