| NPI | 1952354722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IN 35001576A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39001766A) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2013-02-21 |