| NPI | 1407025372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC04866100) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2019-04-25 |