| NPI | 1992433288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC06305500) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44SL06681000) |
| Enumeration Date | 2022-08-12 |
| Last Update Date | 2024-02-03 |