| NPI | 1144466764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NJ 37PC00345900) |
| Additional Taxonomies | 221700000X Art Therapist |
| Enumeration Date | 2009-01-02 |
| Last Update Date | 2009-01-02 |