NPI | 1881835395 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NJ 37F100166800) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2009-03-12 |
Last Update Date | 2013-01-18 |