| NPI | 1598121568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AR F1409013) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AR A1308088) |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2016-01-06 |