| NPI | 1871750950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR 237C) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AR M980314) |
| Enumeration Date | 2008-05-17 |
| Last Update Date | 2008-05-17 |