| NPI | 1861516619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 166.001069) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IN 35001611A) |
| 106H00000X Marriage & Family Therapist (Licence: VA 0717001255) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2016-12-06 |