| NPI | 1396186227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: DC 80000067) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: DC LMFT000098) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2013-07-29 |