| NPI | 1265509673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY R0497021) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ SC51099) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2007-07-08 |