| NPI | 1932490216 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC06241600) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 083308) |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2023-11-12 |