| NPI | 1124340690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NV PA07012014) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NV MI0117) |
| Enumeration Date | 2010-02-24 |
| Last Update Date | 2015-04-28 |