| NPI | 1932773157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NJ 44SL06657900) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA SW137719) |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2024-04-30 |