| NPI | 1922293562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05892200) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 121633) |
| 1041C0700X Social Worker, Clinical (Licence: IL 149014670) | |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2022-06-14 |