| NPI | 1508754086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IN 35002514A) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CT 3646) |
| Enumeration Date | 2025-06-25 |
| Last Update Date | 2026-01-14 |