| NPI | 1659202448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 128805-01) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44SL07426500) |
| Enumeration Date | 2026-05-28 |
| Last Update Date | 2026-05-28 |