| NPI | 1326697947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: ND 2022-084) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 4155) |
| Enumeration Date | 2019-09-06 |
| Last Update Date | 2024-12-16 |