| NPI | 1538399811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 7435) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NJ 37PC00386200) |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2009-07-21 |