| NPI | 1063727360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NE 1343) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NE 9610) |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2015-03-05 |