| NPI | 1417339094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO MFTC0014260) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2022-03-08 |