| NPI | 1851413835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05963800) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44SL04939400) |
| 1041S0200X Social Worker, School | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2022-10-20 |