| NPI | 1740047356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NJ 44sl07067600) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 123010) |
| Enumeration Date | 2024-02-29 |
| Last Update Date | 2026-06-09 |