| NPI | 1033191929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NJ 37F100150400) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT2060) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2025-02-10 |