NPI | 1992569511 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 098130) |
Additional Taxonomies | 104100000X Social Worker (Licence: NY 108550-01) |
Enumeration Date | 2024-02-13 |
Last Update Date | 2024-08-05 |