| NPI | 1952491961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 73-069282) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 069282) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2014-01-28 |