NPI | 1437773736 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 2184-124) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
Enumeration Date | 2020-06-02 |
Last Update Date | 2024-03-27 |