NPI | 1114018603 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY R036723-1) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC00354600) |
Enumeration Date | 2006-09-27 |
Last Update Date | 2023-12-01 |