| NPI | 1225232689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NY 000500) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NJ FI01491) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2007-09-27 |