| NPI | 1609933217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NJ 44SC01271100) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA CW005478L) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2007-07-08 |