| NPI | 1083010110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: HI 776) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2023-08-22 |