| NPI | 1427557545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 208000485) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178012385) |
| Enumeration Date | 2018-02-04 |
| Last Update Date | 2018-02-04 |