| NPI | 1568421238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC00157400) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY PRO29397-1) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2008-06-03 |