NPI | 1427401348 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44sc05821000) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SL06174800) |
Enumeration Date | 2016-07-15 |
Last Update Date | 2020-01-28 |