| NPI | 1447414743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO 826) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: UT 8779842-3902) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2024-08-22 |