| NPI | 1316268113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 166001032) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AR P1111086) |
| 106H00000X Marriage & Family Therapist (Licence: AR M1206007) | |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2016-11-01 |