| NPI | 1699922393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: HI 356) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NV 5106-R) |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2025-08-14 |