| NPI | 1124469853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OH F.1800052) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 78017) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2018-08-14 |