| NPI | 1437411337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44sc04381100) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA cw015698) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2012-06-15 |