| NPI | 1598120958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00792000) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NJ 37AC00263500) |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2025-07-15 |