| NPI | 1023203007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: PA MF001023) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC49843) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2018-10-01 |