| NPI | 1972487239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 208.001372) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 157426) |
| Enumeration Date | 2025-07-31 |
| Last Update Date | 2025-08-23 |