| NPI | 1922764273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37AC00440200) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: NJ 1094746) |
| Enumeration Date | 2021-11-11 |
| Last Update Date | 2021-11-11 |