| NPI | 1497958722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AR M0907004) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OK 829) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2024-06-04 |