| NPI | 1477156370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 132078) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44SL07486500) |
| Enumeration Date | 2020-11-21 |
| Last Update Date | 2026-07-02 |