| NPI | 1578883526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00021600) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NJ 37PC0021600) |
| Enumeration Date | 2010-06-01 |
| Last Update Date | 2018-08-22 |