| NPI | 1043162738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 127671) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44sl07284700) |
| Enumeration Date | 2026-02-13 |
| Last Update Date | 2026-02-13 |