NPI | 1023792512 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC06206500) |
Additional Taxonomies | 104100000X Social Worker (Licence: NY 109963) |
Enumeration Date | 2023-06-14 |
Last Update Date | 2023-06-14 |