| NPI | 1841845195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC06012200) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SL06444700) |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2025-06-10 |