| NPI | 1851455737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37pc00112900) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 000648) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2025-09-11 |