| NPI | 1548698939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34009796A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05635000) |
| Enumeration Date | 2013-10-22 |
| Last Update Date | 2024-08-15 |