| NPI | 1386376846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NJ 44SL06318000) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 101YM0800X Counselor, Mental Health | |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2022-06-24 |
| Last Update Date | 2022-06-24 |