| NPI | 1134529043 |
|---|---|
| Former Name | ELIZABETH NITZBERG |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2014-08-27 |