| NPI | 1932160173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY R17497) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY R17497) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2008-05-21 |