NPI | 1457603417 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CT 1712) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
Enumeration Date | 2012-10-15 |
Last Update Date | 2015-02-20 |