| NPI | 1316561442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00864400) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2024-03-06 |