| NPI | 1205263613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NJ 44SL05682000) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 083470-1) |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2013-09-30 |