NPI | 1750562146 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: DE FT-0000010) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MD LCM010) |
Enumeration Date | 2007-11-14 |
Last Update Date | 2007-11-14 |