NPI | 1366512261 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY R0242041) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC00265200) |
Enumeration Date | 2006-11-08 |
Last Update Date | 2007-07-08 |