| NPI | 1033602644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 3577) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: ND 2016-031A) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2018-06-08 |