| NPI | 1538383534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: IN 34001441A) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IN 35000740A) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2007-07-08 |