| NPI | 1407944242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OH F.1600004) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IN 35001489A) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2016-06-30 |