| NPI | 1144333618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO MFT.0001123) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NJ 37FI00113200) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2014-09-22 |