| NPI | 1043365687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC00036400) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 1041C0700X Social Worker, Clinical (Licence: NY R0330191) | |
| 106H00000X Marriage & Family Therapist (Licence: NJ 37F100011500) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2021-08-09 |