| NPI | 1558783076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 9323286-3902) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OH M.1200037) |
| Enumeration Date | 2014-01-17 |
| Last Update Date | 2019-02-12 |