| NPI | 1467545665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AR M1010008) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OK 967) |
| 106H00000X Marriage & Family Therapist (Licence: MO 2012012968) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2024-02-07 |