| NPI | 1427598358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SL06126200) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05768700) |
| Enumeration Date | 2017-02-25 |
| Last Update Date | 2021-01-21 |