NPI | 1285997577 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 1018-124) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 2628) |
Enumeration Date | 2012-06-21 |
Last Update Date | 2024-03-14 |