| NPI | 1942368626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IN 35000871A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34000428A) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2016-05-19 |