| NPI | 1861129652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NY 001992-01) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CT 2851) |
| Enumeration Date | 2022-08-02 |
| Last Update Date | 2022-09-22 |