| NPI | 1720484223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NC 20081) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2024-07-10 |