| NPI | 1487946281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: GA MFT001248) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC005415) |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2024-02-28 |