| NPI | 1386986305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NJ 37FI00166900) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: PA MF000564) |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2020-04-08 |