| NPI | 1528840246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 44SL07040000) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44SL07040000) |
| Enumeration Date | 2023-10-17 |
| Last Update Date | 2024-07-25 |