| NPI | 1144342049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: LA 830) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA 2841) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2010-06-24 |