| NPI | 1245768647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 106001254) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IL 208000367) |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2019-01-09 |