NPI | 1265796817 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NV 454) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 15091) |
Enumeration Date | 2012-06-28 |
Last Update Date | 2012-06-28 |