| NPI | 1417407156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO MFTC.0013835) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CO NLC.0106066) |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2018-10-05 |