| NPI | 1225875248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 123909) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44SL07146500) |
| Enumeration Date | 2024-07-09 |
| Last Update Date | 2024-07-11 |