NPI | 1437196615 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IA 000324) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 180005090) |
Enumeration Date | 2006-05-31 |
Last Update Date | 2011-02-04 |