| NPI | 1396871455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ PC 02392) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NJ FI 01398) |
| Enumeration Date | 2007-02-25 |
| Last Update Date | 2016-05-19 |