| NPI | 1316235609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IN 35000979A) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IN 33002251A) |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2011-07-20 |