NPI | 1013614957 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AZ 10842) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 204061) |
Enumeration Date | 2023-02-10 |
Last Update Date | 2023-02-10 |