| NPI | 1144901976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TN 2308) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TN 1234) |
| Enumeration Date | 2023-07-25 |
| Last Update Date | 2023-07-25 |