| NPI | 1659452068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OH F.0900007) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KY 0700) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2021-03-12 |