| NPI | 1306162029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TN 1283) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT3793) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2024-01-31 |