| NPI | 1457555195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NJ 44SL05537400) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NM X05825) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2009-07-08 |