| NPI | 1033568415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 166.001097) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OH F.2600635) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2026-09-09 |