| NPI | 1346296092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW013725) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2010-07-08 |