| NPI | 1720266687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 14780) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05340400) |
| 1041C0700X Social Worker, Clinical (Licence: NY R059937-1) | |
| Enumeration Date | 2008-02-03 |
| Last Update Date | 2016-03-02 |