| NPI | 1568388569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NJ 44SL07475800) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 131930) |
| Enumeration Date | 2026-06-25 |
| Last Update Date | 2026-07-20 |