| NPI | 1538504477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NM CMF0199731) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: HI MFT 341) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2019-12-31 |