| NPI | 1548917958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NV 4776) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NV MI2843) |
| Enumeration Date | 2022-03-05 |
| Last Update Date | 2024-09-21 |