| NPI | 1235585993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NJ 44SL06171000) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 097418-1) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2016-07-18 |