NPI | 1134805948 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 2798) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 2049-124) |
Enumeration Date | 2023-06-26 |
Last Update Date | 2023-06-26 |