| NPI | 1972719623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NJ 37FI00038300) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: 972) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2014-09-02 |