| NPI | 1427539246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OK 10310) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KS 03065) |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2024-02-14 |