| NPI | 1063769354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 166000972) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IL 208000264) |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2020-05-11 |