| NPI | 1518416015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00560000) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: DE PC-0000711) |
| 101YP2500X Counselor, Professional (Licence: PA PC008809) | |
| Enumeration Date | 2016-09-25 |
| Last Update Date | 2016-09-25 |