| NPI | 1659411668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AZ 15131) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NH 98) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2021-04-22 |