NPI | 1023228640 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MS T0382) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA MFT001031) |
Enumeration Date | 2007-05-23 |
Last Update Date | 2007-07-08 |