| NPI | 1942418157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NY 718) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NY P54396) |
| Enumeration Date | 2007-05-19 |
| Last Update Date | 2009-06-10 |