| NPI | 1831679679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00598500) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA PC010298) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2025-02-05 |