| NPI | 1144551821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OH F1900092) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 2102) |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2019-09-30 |