| NPI | 1124455225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P1611178) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AR M1612010) |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2024-05-31 |