| NPI | 1396265799 |
|---|---|
| Former Name | JOSEPH OSTAVIOLOUIS SURANO DHARA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 571-228) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2023-06-19 |