| NPI | 1700026903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WY LMFT-092) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MT 26001) |
| Enumeration Date | 2009-02-27 |
| Last Update Date | 2024-03-07 |