| NPI | 1215230271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IN 35001965A) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: PA MF000676) |
| Enumeration Date | 2010-12-14 |
| Last Update Date | 2024-05-14 |