| NPI | 1346677564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05861300) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44SL06116200) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2019-06-04 |