| NPI | 1144357880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NH 65) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: VT 100-0000041) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2007-07-08 |