| NPI | 1467223016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 121800) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44SL07052900) |
| Enumeration Date | 2024-01-12 |
| Last Update Date | 2024-01-12 |