NPI | 1306013958 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AL 114) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AL 106) |
Enumeration Date | 2008-05-13 |
Last Update Date | 2008-05-13 |