| NPI | 1225132558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY R028867) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ SC00739) |
| 104100000X Social Worker (Licence: NY 5203) | |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2007-07-08 |