NPI | 1992932479 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L6016) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 069903-1) |
1041C0700X Social Worker, Clinical (Licence: NY 069903) | |
Enumeration Date | 2009-06-11 |
Last Update Date | 2014-09-22 |