| NPI | 1174347793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 125177) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44SL07153500) |
| Enumeration Date | 2024-11-11 |
| Last Update Date | 2024-11-11 |