| NPI | 1902870900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NJ 37F100003400) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC00083100) |
| 1041C0700X Social Worker, Clinical (Licence: ND PR022930-1) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2025-09-11 |