| NPI | 1528877925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 125313) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44SL07196900) |
| Enumeration Date | 2025-01-01 |
| Last Update Date | 2025-01-01 |