NPI | 1396800348 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NJ 44SC05205900) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: PA CW014891) |
Enumeration Date | 2006-12-27 |
Last Update Date | 2012-04-05 |