| NPI | 1396161154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 3356) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NV MI0508) |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2022-03-28 |