| NPI | 1992359293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 109022) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44sl06478800) |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2022-02-24 |