| NPI | 1013037639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO MFT.0000830) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2021-06-02 |