| NPI | 1659314094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO MFT.0002531) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KS 695) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2024-03-01 |