| NPI | 1528239399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NH 0029) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: VT 100-0000013) |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2010-02-18 |