NPI | 1619159621 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DE Q1-0001222) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05333700) |
Enumeration Date | 2007-11-30 |
Last Update Date | 2023-04-27 |