NPI | 1629595921 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NC 2122) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC 12054A) |
Enumeration Date | 2017-08-28 |
Last Update Date | 2024-09-11 |