| NPI | 1447250139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC00662600) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ME LC9636) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2007-07-08 |