| NPI | 1184394843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IN 35000727) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34003022) |
| Enumeration Date | 2021-09-15 |
| Last Update Date | 2021-09-15 |