| NPI | 1932556099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05776100) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44SL05994300) |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2024-11-14 |