NPI | 1649440397 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CT 1222) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CT 1222) |
Enumeration Date | 2008-03-10 |
Last Update Date | 2008-05-05 |