| NPI | 1457462723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05304500) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW015214) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2024-05-23 |