| NPI | 1447494232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NV 01147) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: UT 13934506-3902) |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2026-03-24 |