| NPI | 1538193776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TN LMT0000001845) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC 42004) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2022-06-29 |