NPI | 1194116566 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NJ 37F100187200) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
Enumeration Date | 2015-02-06 |
Last Update Date | 2018-10-10 |