| 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 |