| NPI | 1497974406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05345100) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW015827) |
| 1041C0700X Social Worker, Clinical (Licence: DE Q1-0011852) | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2024-07-31 |