| NPI | 1356160022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NJ 44SL06719200) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 120518) |
| Enumeration Date | 2024-10-09 |
| Last Update Date | 2024-10-09 |