| NPI | 1235532011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CT 1708) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NJ 37FI00179800) |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2025-12-08 |