| NPI | 1215039664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral (Licence: NJ 3251) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NJ 37FI00143000) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2007-07-08 |