| NPI | 1154606820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: PA MF000951) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 201734) |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2024-05-28 |