| NPI | 1306902689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 16600997) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC39237) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2018-12-20 |