NPI | 1013970755 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: KY 105259) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IN 35002076A) |
Enumeration Date | 2006-04-11 |
Last Update Date | 2023-11-08 |