| NPI | 1780835579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IN 99034514A) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IL 166000644) |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2008-10-10 |