| NPI | 1063981090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IN 35000355A) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IN 33002808A) |
| Enumeration Date | 2018-11-20 |
| Last Update Date | 2018-11-20 |