| NPI | 1093064016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IN 35001750A.) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AL 437) |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2017-03-18 |