| NPI | 1598198103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00000900) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA PC001872) |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2013-08-19 |