| NPI | 1598442683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NJ 44SL06810900) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 118148) |
| Enumeration Date | 2023-06-29 |
| Last Update Date | 2023-06-29 |