| NPI | 1881234532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC06335500) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CT 011638) |
| Enumeration Date | 2020-01-10 |
| Last Update Date | 2025-05-03 |