NPI | 1528490877 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW018657) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05928700) |
Enumeration Date | 2013-08-08 |
Last Update Date | 2024-09-02 |