| NPI | 1346347721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34003117A) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IN 35001034A) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2009-11-05 |