| NPI | 1568672418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NV 2633-r) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 201064) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2024-01-13 |