| NPI | 1831071430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NJ 44SL07269400) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 116817) |
| Enumeration Date | 2025-07-23 |
| Last Update Date | 2025-07-23 |