| NPI | 1609975168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OH F.2500504) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 45456) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2025-07-01 |