NPI | 1730373739 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44sc05274400) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY R056021-1) |
Enumeration Date | 2007-09-02 |
Last Update Date | 2017-10-19 |