| NPI | 1447552971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 6726) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NJ 37pc00379600) |
| Enumeration Date | 2010-12-05 |
| Last Update Date | 2021-12-13 |