| NPI | 1144332784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NJ 44SC00437900) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NJ 44SC00437900) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |