| NPI | 1740310887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AR A0609064) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: AR A0609064) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2008-04-08 |