NPI | 1619572369 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NC 0305) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC 12266A) |
Enumeration Date | 2020-12-01 |
Last Update Date | 2023-12-07 |