| NPI | 1447250550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: FL SW6) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT6) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2010-08-23 |