| NPI | 1447722970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NV 3320) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 203231) |
| 106H00000X Marriage & Family Therapist (Licence: NV MI1175) | |
| Enumeration Date | 2018-12-21 |
| Last Update Date | 2023-04-17 |