| NPI | 1700981669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: DE PC-0000448) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NJ 37pc00046600) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2024-01-30 |