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 |