| NPI | 1811126659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00366800) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44sw00931400) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2009-07-14 |