| NPI | 1538448766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 2331) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OH F-1500003) |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2024-11-11 |